Why Do Patients Who Have Acute Lung Injury/Acute Respiratory Distress Syndrome Die from Multiple Organ Dysfunction Syndrome? Implications for Management

ARDS still has high mortality rates, usually in the region of 40% to 50%. Although ARDS is the most severe form of acute respiratory failure, refractory hypoxia is an uncommon cause of death in these patients. ARDS should be seen as a systemic disease, and the majority of patients who have ARDS die from MODS. Therefore, systemic management is of paramount importance and must focus primarily on treatment of the underlying cause (eg, the infection causing the sepsis). Other treatments are primarily supportive and include ensuring sufficient fluid administration to maintain blood flow without causing edema and ventilatory support with low tidal volumes. Improved understanding of the systemic factors involved in the development and evolution of ARDS and MODS should facilitate the development of new therapeutic agents that may improve outcomes in these patients.